Prescription Drug Abuse: Side Effects, Withdrawal and Treatment

Prescription drug misuse is taking medication in a different way than prescribed. In the United States, an estimated 16.3 million people misuse prescriptions in a year. Misusing prescription medicines can lead to addiction, overdose and death.  

There is a misconception that because a particular drug is prescribed, it is safe; however, many prescription drugs have dangerous side effects, can be misused and cause withdrawal symptoms that require treatment. 

What Are Prescription Drugs?

Prescription drugs are medications that require special permission or a prescription from a qualified medical professional. They are not available over-the-counter and must be dispensed by a licensed pharmacy. 

There are essentially two types of prescriptions, non-controlled and controlled medications. Non-controlled medications are used for chronic conditions, such as asthma, diabetes and mental illnesses and usually have low to no risk for dependence. They may also be used to treat infections. Controlled substances are medications that have a risk for physical or psychological dependence, leading to withdrawal when the medication is stopped. These medicines may be used, for example, to treat pain or attention-deficit/hyperactivity disorder (ADHD).

Prescription Drug Classes

The Drug Enforcement Administration (DEA) has classified controlled drugs into five different groups known as schedules. They are numbered I to V (in Roman numerals) and classify drugs based on their addiction and misuse potential. 

The controlled drug schedule includes:

• Schedule I: These have the highest risk for misuse and are considered to have no medicinal value. Examples include heroin, lysergic acid (LSD) and mescaline.
• Schedule II: These have a high risk of physical and mental dependence but have medicinal value. Examples include morphine, oxycodone and amphetamine.
• Schedule III: These may cause physical dependence but more commonly lead to mental dependence. Examples include ketamine and anabolic steroids.
• Schedule IV: These medications have less risk for physical or psychological dependence. Examples include benzodiazepines and carisoprodol.
• Schedule V: These have limited risk for physical or psychological dependence. Examples include codeine and pregabalin.

Commonly Dispensed Prescription Drugs

There are four main classes of commonly dispensed prescription drugs with the potential for misuse. These drugs can lead to withdrawal if stopped abruptly, which can be painful, uncomfortable and, in some cases, dangerous. The four classes of drugs are opioids, stimulants, central nervous system (CNS) depressants and antipsychotics. 

Opioids

Opioids are controlled medications given to treat moderate to severe pain after major events such as injury or surgery. Additionally, they can be used in some cases to treat coughing and diarrhea. They work by binding to opioid receptors in the brain, causing feelings of pleasure. Opioids are typically classified as Schedule II drugs with high potential for misuse and dependence. As a result, they are some of the most commonly misused substances.

Stimulants

Stimulants are controlled drugs that treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy, a condition that causes uncontrollable deep sleep. The main effects of stimulants are increasing energy, attention and alertness. Stimulants achieve these effects by boosting levels of the neurotransmitters dopamine and norepinephrine, which causes a euphoric feeling, sometimes described as a “rush.” This rush can become addictive and has a high potential for abuse, leading stimulants to be classified as Schedule II drugs.

CNS Depressants

CNS depressants are controlled drugs that treat panic disorder, anxiety and insomnia. They work by binding to gamma-aminobutyric acid (GABA) receptors in the brain, which slows electrical activity, creating feelings of sedation and relaxation. CNS depressants are Schedule IV drugs that have some potential for misuse and dependence.

Antipsychotics

Antipsychotics are prescription drugs that treat psychosis or conditions that may affect a person’s perception of reality and can include hallucinations or delusions. They are used to treat a variety of mental health conditions, including schizophrenia, bipolar disorder and a severe form of depression known as psychotic depression. Although they are not controlled substances, individuals can experience withdrawal when stopping these medications. Examples of antipsychotic medications include Haldol, Zyprexa, Abilify and Seroquel.

Prescription Drug Abuse

Prescription drug abuse may occur in different ways. It is considered misuse or abuse if an individual takes a medicine prescribed to somebody else, more medication than what was prescribed to them or if taken differently than prescribed. For example, crushing a tablet of oxycodone and snorting it rather than swallowing the pill orally is drug abuse. Taking prescribed medicine when it is not needed at that specific time is also considered drug abuse. For instance, a person who was prescribed morphine for severe pain but then takes the medication to feel the euphoric effect even though the pain has subsided is abusing the morphine.  

One interesting point is that most people don’t misuse a drug with the intention to obtain a rush or feeling of euphoria. In fact, only fewer than 1 in 10 people misuse drugs to get high. Many people develop a tolerance to certain drugs. This means that a higher dose of a medication is required to achieve the same effect. Tolerance is very common among individuals who suffer from chronic pain and require opioids to control that pain.

It is crucial to address prescription drug abuse, as it can have dangerous consequences. Abusing prescription drugs can lead to addiction, overdose and death. In the last 15 years, there has been a substantial increase in emergency room visits and overdose deaths as a result of prescription drug misuse.

Commonly Abused Prescription Drugs

The most commonly abused prescription drugs are CNS depressants, opioids and stimulants.

Prescription CNS depressants commonly abused are:

• Barbiturates: These may be classified as Schedule II, III or IV drugs that can be injected or swallowed. Examples of barbiturates include Amytal and phenobarbital. Street names include barbs and phennies.
• Benzodiazepines: These are classified as Schedule IV drugs that are swallowed. Examples of benzodiazepines include Ativan, Librium, Xanax and Klonopin. Some street names for this class of drugs are downers and tranks.
• Sleep medications: These are classified as Schedule IV drugs that are swallowed. Examples of sleep medications include Ambien, Sonata and Lunesta. Zombie pills is a street name for Ambien.

Commonly abused prescription pain medications, such as opioids and morphine derivatives, include:

• Codeine: This is classified as a Schedule II, III or IV drug depending on other medications it is combined with, and it can be injected or swallowed. Examples of codeine-containing drugs include Robitussin A-C and Tylenol with codeine. Some street names for codeine are cody and schoolboy.
• Morphine: This is classified as a Schedule II or III drug and can be injected, swallowed or smoked. Street names for morphine include Miss Emma and monkey.
• Methadone: This is classified as a Schedule II drug and can be swallowed or injected. Methadone may also be referred to as fizzies on the street. 
• Fentanyl: This is classified as a Schedule II drug and can be injected, smoked or snorted. Street names for fentanyl include dance fever, goodfella and TNT.
• Other opioid pain relievers: These are classified as Schedule II, III or IV drugs and can be chewed, swallowed, snorted, injected or used as a suppository. Examples include Oxycontin, Percocet, Vicodin, and Dilaudid. These drugs on the street may be called hillbilly heroin, percs, juice and smack.

Commonly abused prescription stimulants include:

• Amphetamines: These are classified as Schedule II drugs and can be injected, swallowed, smoked or snorted. Examples of amphetamines include Dexedrine and Adderall. Amphetamine street names are speed, truck drivers and uppers.
• Methylphenidate: This is classified as a Schedule II drug and can be injected, swallowed and snorted. Examples of methylphenidate include Concerta and Ritalin. Street names for this drug include skippy and vitamin R.

Side Effects of Prescription Drug Abuse

The side effects a person experiences from abusing prescription drugs will vary depending on the type of drug. There are short-term and long-term effects associated with prescription drug abuse.

Short-Term Side Effects

Short-term side effects of prescription drug abuse include: 

• Extreme sleepiness
• Upset stomach
• Constipation
• Fever
• Increased heartbeat
• Paranoia
• Slurred speech
• Feeling disoriented
• Lack of coordination
• Difficulty breathing or slowed breathing

Long-Term Side Effects

Long-term side effects that may occur from prescription drug abuse include:

• Respiratory depression
• Seizures
• Psychosis
• Cardiovascular failure
• Dependence
• Addiction
• Overdose
• Death

It is important to point out that for children, adolescents and young adults, the risk for long-term side effects is worse. A human’s brain is not fully developed until at least their early twenties. Abusing prescription drugs before this age can affect the developing brain structurally, which may affect how a person understands certain things like social norms. It can also lead to a higher susceptibility for addiction. 

Prescription Drug Withdrawal

If an individual abuses a medication, they are at risk of experiencing withdrawal. Withdrawal occurs when a person abruptly stops taking a medication or greatly reduces the dose of a medicine. The symptoms experienced during withdrawal can be extremely unpleasant, difficult and dangerous. Because of this, withdrawal symptoms are best managed under the care of licensed medical professionals. 

CNS Depressant Withdrawal Symptoms

Withdrawal symptoms generally begin within one to two days after the last dose and can last for eight weeks or longer. Symptoms associated with withdrawal from these drugs include:

• Anxiety
• Insomnia
• Restlessness
• Agitation
• Irritability
• Difficulty concentrating
• Impaired memory
• Muscle aches

Stimulant Withdrawal Symptoms

Symptoms may begin within 24 hours from the last dose of the drug and can last for five days. Possible withdrawal symptoms from stimulants include:

• Irritability
• Agitation
• Depression
• Sleepiness
• Increased appetite
• Muscle aches
• Paranoia
• Hallucinations
• Disorganized thoughts

Opioid Withdrawal Symptoms

Depending on the type of opioid that is being used, symptoms can begin anywhere from 8 to 48 hours from the last dose and last between 4 to 20 days. Opioid withdrawal symptoms include:

• Nausea
• Vomiting
• Anxiety
• Inability to sleep
• Sweating
• Muscle cramps
• Watery eyes and runny nose
• Diarrhea
• Heart racing
• Feeling cold
• Twitching
• Achiness

Antipsychotic Withdrawal Symptoms

Withdrawal symptoms for antipsychotic medications typically begin within four weeks after abrupt discontinuation. Symptoms associated with withdrawal from these drugs include: 

• Nausea
• Vomiting
• Abdominal cramps
• Diarrhea
• Headache
• Increased heart rate
• Loss of balance
• Sweating
• Dry mouth
• Muscle pain
• Restlessness
• Anxiety
• Insomnia
• Muscle spasm

Treatment Programs for Prescription Drug Abuse

Coping with prescription drug addiction is difficult, and withdrawal from prescription drugs should always be managed under the direct supervision of a licensed medical professional to prevent dangerous effects. Orlando Recovery Center is an accredited facility that offers different levels of care to anyone struggling with prescription drug abuse. 

The first step is medical detox. Detox is the gradual removal of a substance from the body. Our empathetic and expert health care professionals will guide you through this process to avoid or minimize any uncomfortable symptoms that may arise. Medications may or may not be administered depending on the severity of your individual situation. After detox is complete, a transition will be made into an addiction rehab program that best fits your individual needs. This may include inpatient treatment, in which the client lives onsite, or outpatient care, where they live at home during their treatment. Rehab treatment often involves group and individual therapy, medical care and monitoring, peer support meetings and progress reviews. 

Treatment for Dual Diagnosis

A dual diagnosis refers to someone who experiences mental health and substance use disorders simultaneously. In the United States, an estimated 17 million adults had both a mental illness and substance use disorder in 2020. Orlando Recovery Center’s dual diagnosis treatment program is equipped to treat the whole person, including their substance abuse and any co-occurring mental conditions for the greatest chance for success. 

Support for Prescription Drug Abuse in Orlando, FL

Orlando Recovery Center offers clients a full continuum of care, including medical detox, inpatient and outpatient care several levels of care in between. There are also an array of amenities, including: 

• Swimming pool
• Fully equipped fitness gym
• Basketball courts
• Sand volleyball courts
• Yoga
• Art therapy
• Designated smoking areas
• Lakefront views

Our facility is conveniently located in the heart of downtown Orlando, roughly 20 minutes from the Orlando International Airport. If you or someone you know is struggling with prescription drug abuse, contact us today to speak with one of our helpful representatives who can answer your questions and get you started on the road to lifelong recovery. 

Editor – Abby Doty

Abby Doty graduated from Hamline University in 2021 with a Bachelor's in English and Psychology. She has written and edited creative and literary work as well as academic pieces focused primarily on psychology and mental health. Read more